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This Alert describes 205 cases of illness or injury in workers exposed to phosphine gas associated with phosphide fumigants. Information about these exposures is urgently needed by agricultural workers, employers, cooperative extension agents, physicians, and other health care providers. NIOSH therefore requests that editors of trade journals, safety and health officials, labor unions, and agricultural employers bring this Alert to the attention of all workers who handle products that generate phosphine gas. Phosphide fumigants release toxic phosphine gas (PH3) when they contact moisture in the air. When phosphine is inhaled, it can react with moisture in the lungs to form phosphoric acid, which can cause blistering and edema. These effects can be serious or fatal. Exposure to phosphine has also been linked with other effects such as chest tightness, headache, dizziness, and nausea. Also, improper handling of aluminum and magnesium phosphide has caused injuries from flash fires and explosions. In 1988, NIOSH published survey results showing that worker exposure to phosphine often substantially exceeded the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) [Zaebst et. al. 1988]. The case reports described in this Alert clearly illustrate the hazards to workers who handle or work near phosphide fumigants.